1. - Pain and discomfort

This facet explores unpleasant physical sensations experienced by a person and, the extent to which these sensations are distressing and interfere with life. Questions within the facet include the control the person has over the pain and the ease with which relief from pain can be achieved. The assumption is made that the easier the relief from pain, the less the fear of pain and its resulting effect on quality of life. Similarly changes in levels of pain may be more distressing than pain itself. Even when a person is not actually in pain, either through taking drugs or because the pain is by its very nature on and off (e.g. migraine), his/her quality of life may be affected by the constant threat of pain. It is acknowledged that people respond to pain differently, and differing tolerance and acceptance of pain is likely to affect its impact on quality of life.

Unpleasant physical sensations such as stiffness, aches, long-term or short-term pain, or itches are included. Pain is judged to be present if a person reports it to be so, even if there is no medical reason to account for it.

2. Energy and fatigue

This facet explores the energy, enthusiasm and endurance that a person has in order to perform the necessary tasks of daily living, as well as other chosen activities such as recreation. This may extend from reports of disabling tiredness to adequate levels of energy, to feeling really alive. Tiredness may result from any one of a number of causes, for example illness, problems such as depression, or over-exertion.

The impact of fatigue on social relationships, the increased dependence on others due to chronic fatigue and the reason for any fatigue are beyond the scope of questioning, although they are implicit to the questions in this facet and facets concerned specifically with daily activities and interpersonal relationships.

3. Sleep and rest

This facet concerns how much sleep and rest, and problems in this area, affect the person’s quality of life. Sleep problems might include difficulty going to sleep, waking up during the night, waking up early in the morning and being unable to go back to sleep and lack of refreshment from sleep.

The facet’s focus is on whether sleep is disturbed or not; this can be for any reason, either to do with the person or to do with the environment.

The questions in this facet do not inquire into specific aspects of sleep such as waking up early in the morning or whether or not a person takes sleeping pills. The question of whether a person is dependent on substances (e.g. sleeping pills) to help him/her sleep is covered in a separate facet.